
You might've heard the qualifier that exercise is good for you – but you need to be progressing that exercise over time. Running further, lifting heavier, exercising for longer. How important is it to up the stakes? Norman and Tegan flex their muscles on progressive training and its benefits. References: Thomas L. DeLorme and the Science of Progressive Resistance Exercise Associations of Muscle Mass and Strength with All-Cause Mortality among US Older Adults Skeletal Muscle Strength as a Predictor of All-Cause Mortality in Healthy Men Progressive overload without progressing load? The effects of load or repetition progression on muscular adaptations Strength and Hypertrophy Adaptations Between Low- vs. High-Load Resistance Training: A Systematic Review and Meta-analysis Physical activity types, variety, and mortality: results from two prospective cohort studies If you enjoyed this episode, check these out! Working out? Why 'No Pain No Gain' is bull Is a vibration plate wort...
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A
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B
ABC Listen, podcasts, radio, news, music, and more.
C
Hey there, Sana Qadar here from all in the Mind. Check out our new series Forensic. It's all about the psychological tools and tricks that come with investigating crime.
B
He was setting the bombs off in
D
subways, in the New York Public Library, in movie theaters.
A
When you're testifying in court, rather than having purely your own memory, you take on all these little bits and pieces of information from different sources.
C
All in the Mind Forensic Search for All in the Mind on ABC Listen or wherever you get your podcasts.
B
So, Norman, we had a Mother's Day picnic on the weekend, and my nephew told me a joke that I would like to share with you. What musical instrument does a doctor play?
D
I don't know. What musical instrument does a doctor play?
B
The organ. I thought it was so cute. My first thought was like, I can't wait to tell Norman.
D
Very good, very good. I'm chuckling internally. You know, sure. I'm having a big chuckle.
B
You're playing your internal organs. Yes, fair.
D
That's right. Yeah.
B
And it has absolutely no bearing on this week's topic of what's that?
D
Rash, which is on progressive exercise. This is the podcast where we answer the health questions that simply everyone's asking.
B
So Ryan has emailed us to talk about progression in exercise. Ryan says, I've heard you mention progression in exercise a few times now. I understand the concept, but there must be a limit. Ryan says, I'm in my mid-40s and I'm past any desire to look like a bodybuilder at the moment. I naturally diversify my exercises in order to stay interested and motivated. Can you rest the progression by doing another exercise for a few weeks and then picking up the weights again? Ryan says, I'm too old to grow a thick neck, but if I don't exercise for about a month, it's hard to get out of bed. Am I wasting my time throwing the same weight around for too long? Incredible questions, Ryan. I love this. So we will definitely touch on each of the parts of Ryan's question, but broadly. Norman, progressive exercise. What are we talking about here we're
D
talking about exercise, where as an exercise or an activity becomes easier to do, you make it harder as time goes on. So, for example, if you've not done any exercise and you're getting up off the proverbial couch and you decide to go for a 20 minute walk along the flat and you find that you get a little bit breathless after a couple of weeks, you won't be so breathless. So you might want to do your 20 minute walk in 15 or you do a 30 minute walk or you add some hills and stairs so that you stay as breathless as you could remember after getting off the bench. And with weights, we can get into the weeds with this a little bit. But with weights it means when you start off doing weight training and it's getting easier over a period of time, you increase the weights so that you're using the same effort, if you like, with higher weights in terms of building up either muscle bulk or, or muscle strength.
B
So we're sort of talking about two potential avenues here. You can build up your cardiovascular strength or fitness. So let's say I do a couch to 5K or I'm training for a marathon and I'm progressively getting my cardiovascular endurance higher, or. And it's probably both of the things at the same time, I'm working on building my muscle strength and endurance and size up.
D
That's right.
B
But it's the same kind of ladder.
D
Yeah, it's, it's increasing the workload. So to use gym terminology, let's say you start off doing biceps exercises with three kilo weights. After a couple of weeks you might go up to 4 kilo weights, then 5 and so on, and then you move up. But another way that's progressive is you might be doing 13 reps at 4 kilos and then you go up to 20 reps. And so there's this big debate in the progressive exercise community which counts more reps or increasing the weight.
B
So I think today we'll focus a bit more on resistance training, that is weight training and building muscle.
D
And before you do that. Good point. But most resistance training is aerobic as well. So just try doing say 15 squats, particularly if you're holding a weight. You're gonna be pretty breathless at the end of that. So there's plenty.
B
Yeah, I'm blowing pretty hard at the end of a set of heavy lifts.
D
Yeah, there's plenty of weight training where you get both here. So you shouldn't think of it just as muscles. You're exercising your heart as well. I Interrupted you, but you're going to give us some fascinating history here, as you always do.
B
Well, I want to ask you a question. This is something that I feel like we maybe don't appreciate, how much medicine has changed in quite a short period of time. So if you were having an orthopedic surgery these days, how long would you typically spend in hospital recovering after that?
D
Well, they're down to same day knee replacements.
B
Right. In the 40s it was like six to nine months. And if you remember anything about the 1940s, it was a time where a lot of people were, were having orthopaedic surgeries because they were returned soldiers. So it was a time when there was a lot of demand for reconstructive and orthopaedic surgery and there was this huge backlog as these soldiers were coming back, this is in the States, were coming back from war and then they've had these long waiting lists to be treated because people were in hospital for such a long time. And there was a doctor who was doing the rounds at that time, Thomas Delorme, and he thought it wasn't the doctor shortage that was causing the backlog, it was this need for a more efficient rehabilitation scheme. Cause at the time, rehab basically looked like rest, heat and high repetitions of exercises with very little resistance. And the idea behind them was just to get the blood back into the muscle rather than building the muscle itself.
D
Because there was a theory then that if actually if you worked too hard, it was bad for your heart.
B
Well, it's funny because that was the saying of a very famous media doctor, Norman. He was a syndicated newspaper columnist, we're talking about Dr. William Brady. And he said, yeah, extreme effort was no good in exercise for the heart. And just like in general, it just wasn't. It wasn't seen to be healthy.
D
Yeah. And the whole idea was it was good to go to bed, just lie in your bed.
B
Look, you know, I'm not going to argue with that. However, it seems that the evidence is not in my favour because this man, Thomas Delaune came along and his backstory was that he had had rheumatic fever when he was a kid and he was sent to bed like you said, and he lost a lot of muscle in that time and got very, very underweight and thin and weak. But while he was lying in bed, he was reading Strength and Health magazine, which at that time in the 20s and 30s was, you know, it's like
D
Charles Atlas, you know, don't be a 90 pound weakling and have People kick sand in your face.
B
Yeah, those. Like those flexing men with their big biceps. So Delaume was like, yes, this is my future. I want to be a flexing bicep man. And so when he got out of bed after being sufficiently rehabilitated from rheumatic fever, and he was told because of that, that his heart was weak and that he wouldn't be able to do a lot of exercise at any point in his life, and he pretty much set out to prove his doctors wrong and became a doct himself and got super into weightlifting. He was bench pressing, he was deadlifting, he was breaking all sorts of records. He was from Alabama and one of the local newspapers dubbed him Bama Hercules because of how he looked.
D
Delorme was ripped.
B
It was certainly ripped. So basically, this is what he's sort of entering the medical profession with as his history, his own experience of rehabbing himself. And then he's seeing this backlog of people with injuries, orthopedic surgeries, realising that the sort of rehab exercises they were doing didn't kind of gel with what his experience had been. And so he started trying to give people heavier exercises to do instead and started getting good results. And it's fascinating to sort of see what he came up with and realise if you've ever done a session with a personal trainer or a weights class or asked ChatGPT to design your weights
D
program, it's exactly what Delorme did all these years ago.
B
It's basically that it's three rounds of about 10 reps and add weight as you get stronger. It's crazy to me because I love going and lifting up heavy things and putting them down again. The stuff he was developing in the 40s and 50s is still what we're
D
using today, and it's been supplemented by more active research, which is good. And he's shown that it's actually not bad for the heart. It's pretty good for the heart, actually.
B
I need to add one more thing. So the reason we call it progressive resistance exercise is because the idea of heavy weightlifting was a bit scary for people at the time because they'd been warned off it by the media. Dr. It was actually his wife, Eleanor, who coined the term, which I love. She's a woman in stem, she's a woman in spin. Here we are. That's why we call it that now.
D
Amazing. So we've got evidence, though, that it does work beyond Delorme's own work. If you are a lifelong exerciser, you delay the onset of chronic disease. Your muscles are highly metabolic tissue. They are involved in keeping insulin efficient. And when insulin starts to become inefficient and there's resistance to insulin, you get your blood pressure pressure going up, you deposit fat, you increase the risk of diabetes. There's also muscle cross talk which is increasingly recognizes that muscles talk to your gut. Muscles are actually endocrine organs, they produce hormones.
B
What are they saying?
D
Well, they're saying, aren't we cool here?
B
They're saying, I'm so weak, why can't I lift up this heavy weight? That's what my muscles are saying.
D
I'm reminded of a cartoon in the New Yorker where there are some Romans in their togas standing around the forum having a chat. And one of the guys says to the others, look, if you just hold your toga like this, it really shows your biceps off nicely. Anyway, muscle strength is incredibly important. All cause mortality goes down, keeps your blood pressure down, your blood sugar down, and our muscle mass decreases steadily per decade after the age of 30. So that is a track, if you do nothing about it, to frailty and premature death.
B
So I wanna, I know you're saying that you kind of can't really separate muscle strength training and cardio, but you kind of can a little bit. And when I sort of refresh my memory on what the physical activity guidelines are for adults, before we chatted, we've got the guidelines around moderate to vigorous physical activity. And then in addition to that, it says muscle strengthening activities on two or more days per week. But it doesn't give a lot of detail about what that looks like. And it also says, and I'm pretty sure this is part of the new additions that came in quite functional activities targeting mobility, balance and coordination on three or more days per week is doing a Pilates class which is muscle focused, as good as doing like weightlifting.
D
So there haven't been head to head studies. There's no question that there's been better studies of yoga than Pilates and declaration. I do Pilates twice a week and I believe it's helped my core and my balance and made me a much better person than I used to be physically. If not, you know, I'm still an awful person, but you know, physically much better off not falling over all the time. So I think that Pilates is about strength and coordination and you know that brain muscle balance activity as well as strengthen your core. And it's small muscles often that get strengthened with something like Pilates. So the question here is what should be your aim? Should it be muscle hypertrophy in other words, developing big muscles. So I think the evidence would land on your exercise should be actually about building muscle strength. Pilates can help in terms of, particularly in terms of core muscles, but you've got plenty of other muscles in your body that Pilates may not necessarily be focused on. And so it's strength that you're looking for more than just building up muscles themselves.
B
So you mentioned there things like balance. You're not falling over as much, maybe as you get older. This idea of frailty, you want to be able to catch yourself if you start to fall. You want to be able to open a door, open a jar, and have that base level of muscle strength and stave off that muscle decline that you're talking about. And then what we've got in Ryan's question is this idea of progressive exercise. What do we know about maintaining a baseline as your body's aging versus kind of kicking it up a notch and building strength progressively?
D
The answer is not a lot. So if Ryan is doing some exercise with weights, then that's better than not doing exercise at all. There is a little bit of evidence that once you reach a plateau with the exercise that you're doing, your muscles will start to lose mass, even though that you're still doing that exercise. So it's better than not doing it, but you reach a plateau. And if you want to actually maintain and increase your muscle strength as you get older, rather than allowing to decrease, you've actually got to do it progressively. And this brings in the issue, which is to some extent what Ryan was alluding to, which is, do you really need to add on weight or can you increase the reps? So they've done studies where they've compared progressive exercise, progressive resistant exercise, where you progress in terms of the weights that you're using. So same number of reps, but you're increasing the weights versus keeping the weight static but increasing the number of reps. And this is actually going to exhaustion. So where you're really tiring out your muscles, rather than just saying, I've done 10, I'm happy, I can go back and get a cup of coffee. Now, the idea here is that you actually are doing 10 reps, where at the end of, say, three sets of 10, you're finding it hard to exercise that muscle group again because you've gone to exhaustion, and that seems to be the key. And you can do it via reps or weights. And it looks as though there's very little difference between the two. Possibly a little bit of bias towards progressing with weights. But if you increase the reps and your. And you're doing it to exhaustion, you're going to get the same sort of effect.
B
It's funny that someone like Ryan is asking us this question, because I think Ryan is probably an outlier in the fact that he's getting to a stage where he's not sure how to progress further. What we know is that most Australians don't meet the physical activity requirements. So for most of us, this conversation is about starting where you are and then progressing from there. But if you're Ryan and you've already kind of progressed a lot, where is that end point? Like, surely you're not going to get to a stage where you're, like, lifting. You just keep adding a couple of kilos a week until you're lifting like a thousand kilos, because that's just not possible.
D
No, you're not necessarily going to get to that point. But this is where variety counts as well. Ryan talks about variety, and I think he's right in the sense that he's doing variety because he gets bored doing one kind of exercise. And it's like whenever we talk about exercise, is it better in the morning, better at night, what have you, is it. It's better whichever way that you can sustain it. And if Ryan were to do nothing else than just sustain the amount of exercise he's doing at the moment with weights and varying it, he'll be in pretty good shape. But he could be in better shape if he actually did it more progressively. And of course, you're going to reach a limit. And the question is, how many times a week do you do it? Do you have rest days in between? There are all sorts of technical things that if you're really working hard to get yourself up to a high level of fitness and muscle definition, then you would work on. But for average fitness, just making it a little bit harder over a period of time is going to be the right thing to do.
B
It's never going to be a linear curve, though, is it? I think about even professional athletes have, like, on seasons and off seasons. Like Simone Biles isn't doing those flips and probably lifting whatever weight she lifts all the time. It's like you're gearing up for the Olympics or you're gearing up for basketball season or whatever. Watch me display how little I know about sport here. But I wonder how we would even know this. What kind of studies there could have been on this? Because even our most elite sports people aren't always progressing in this linear fashion?
D
No, but they lose strength, you lose cardiovascular fitness. In fact, you lose cardiovascular fitness faster than you lose muscle strength. And you've got to build it back up again. So if you actually give it up for a while, and I don't think these elite athletes give it up completely, they're just not at that level of intensity and they've got these controlled programs which have been fairly well studied and attached to nutrition. So which is the other side of this? Which is you really can't talk about muscle building without making sure that you are on a diet with adequate protein intake, for example. So that when you're building up muscle, you're actually feeding that muscle with protein. Which doesn't mean vast amounts of protein shakes, it just means that you're thinking about protein during the day. So this is not just about muscle training.
B
I guess it depends on what your goals are. If your goals are to have a thick neck, in Ryan's words, then maybe you train that specifically. But if it is as I suspect, just wanting to keep your body as healthy as you can, to live as long as you can, to have a life that is functional and has ease in it that you like. Ryan says that you can get out of bed in the morning without pain. I wonder if we run the risk of overthinking this a bit. Like you say, Norman, do the exercise that you can do consistently and eat well and kind of don't sweat the
D
small stuff, just build it up. I mean, there are certain exercises that you really want to be able to do and do easily, such as squats. Squats help you get up from a sitting position and you want to be really fit and strong. With squats, you probably do want to be doing some push ups because if you fall over or you go down to ground level, you want to be able to push yourself up and get up. So there's some of these exercises where I just don't think you can give up on doing a bit of work.
B
So bottom line for Ryan, do the work, Ryan.
D
Keep the variety up. But you know, you don't have to look like Charles Atlas.
B
But if you want to, I endorse that because.
D
Have you got a thing about Charles Atlas? Have you?
B
No, No. I just think it would be fun to recreate one of those old timey magazine covers just cause it's fun. You have to wear a leopard skin though.
D
You do. And you have to go down to the beach and kick somebody in the face.
B
Ryan, thank you so much for the question. We love that you asked it. I hope that you're in the gym right now lifting a slightly heavier weight than you lifted last week. If you want to email us, you can. Our email address is thatrashbc.net au boring you yawning. Oh, I thought I was boring you, but then I realized you were providing the perfect setup for our mailbag this week.
D
Norman yeah, I just got off a plane for 30 hours in a plane, so the yawning was not entirely but you never bore me.
B
Teen well, I'm now contaged by you because yawning is contagious, as we discussed in our live show that you would have heard in the feed recently and a lot of people have emailed us about it. Actually, Norman, people have come up to me as well and tapped me on the shoulder and said, tegan, I couldn't stop yawning while I was listening to the yawning episode. It was a real problem as long
D
as I didn't fall asleep. Anyway, we've got, you know, what's that Rashers from around the world writing in
B
so Rebecca is in Washington D.C. saying, I'm standing in my kitchen in Washington D.C. listening to the latest episode of what's that Rash And I can't stop yawning. I started yawning almost the second time the word yawn was used. What's worse, this is the second time I've started this podcast. I had to put it away earlier on my first attempt. I think I've yawned about five times while writing this, Rebecca says. Just trying to decide whether to put my head under a cold tap and cool down just to see if it stops. Rebecca's come back to us and said, okay, the cult tap didn't work. I yawned the whole way through and now I look like a yawning wet dog. We'll try to finish the episode and then go out for a strong coffee. Thanks for keeping me entertained. Still yawning. Rebecca, I love your work.
D
Yeah, and you've got to work hard to get a good coffee in Washington D.C. i can privately tell you where to go, but not over the airwaves. And Patti has written from Canada.
B
I made some comment in the episode about whether or not people yawn as frequently in cold climates because one of the theories was that yawning is to cool the brain. Anyway, Patti says, I live in Ottawa and if I haven't dressed adequately on a cold morning's walk, I will start to yawn, something I don't do much of. Otherwise, my Google understanding is that the Y is trying to Reduce the gap between body and brain temperature. That's Paddy's N equals one observation.
D
Thanks, Patti. And Chris has written in.
B
Okay, so Chris says, I just listened to your yawning episode with over ear noise suppressing headphones. Didn't yawn once, but I did many deep inhales and long exhales.
D
Oh, you were cheating, Chris. You were cheating.
B
Yeah, otherwise known as a yawn. Chris Sundays. Anyway, after 20 minutes, I took off the headphones and I had a bout of yawning. Half a dozen in five minutes. So I started playing around with it for the next hour. Headphones on, never yawned. Headphones off. Eventually started yawning again. Put headphones on, yawning stopped, but started the deep inhale. Exhale again. Felt like I wanted to yawn, but I couldn't. Chris, what is going on? Chris is asking, are the ears involved in breathing and do the headphones affect that?
D
So this is where we need the help of all. You watch that, Rashers. Just tell us your headphone stories.
B
We need an N equals more than Chris, please.
D
And Tegan and I are both yawning here and we're both wearing headphones.
B
I am, but they're not noise cancelling, so.
D
No, that's true.
B
More research is required.
D
Indeed.
B
Well, that's it for. What's that? Rash. We'll catch you again next week.
D
Nobody sleeps when what's that Rash is on. We'll see you next time.
Podcast Summary
What's That Rash? – Deep Dive on Progressive Exercise
ABC Australia | May 12, 2026
Episode Overview
This episode of "What's That Rash?" focuses on the concept of progressive exercise, particularly resistance (weight) training, and how to keep improving fitness as we age. The hosts, Tegan (B) and Dr. Norman (D), answer a listener's question about when and how to progress workouts, whether variety counts, and how to avoid plateauing. They also explore the history of modern strength training and provide practical, science-backed advice on making exercise work for you at any age.
Norman explains progressive exercise:
"As an exercise or an activity becomes easier to do, you make it harder as time goes on." (D, 02:32)
Examples:
Distinction between cardiovascular and resistance training:
Both forms of progression apply, and resistance training often has aerobic (cardio) benefits as well.
"Just try doing, say, 15 squats, particularly if you're holding a weight. You're gonna be pretty breathless at the end of that." (D, 04:34)
"It's, it's increasing the workload. So to use gym terminology, let's say you start off doing biceps exercises with three kilo weights. After a couple of weeks you might go up to 4 kilo weights, then 5..." (D, 03:55)
Orthopedic surgery and rehabilitation:
In the 1940s, rehab post-surgery meant a lot of rest and very light work, due to fear exercise would harm the heart.
The Thomas DeLorme story:
“Delorme was ripped.” (D, 07:43)
Benefits of lifelong exercise:
National guidelines:
Resistance vs. Pilates/Yoga:
What if you hit a plateau?
Answers to Listener Ryan:
Diet matters too:
"There are certain exercises that you really want to be able to do and do easily, such as squats...you probably do want to be doing some pushups..." (D, 17:54)
"Do the work, Ryan. Keep the variety up. But you know, you don't have to look like Charles Atlas." (D, 18:27)
The episode is lively, friendly, and conversational, with a dash of banter and historical storytelling. Science is explained clearly but with humour and accessible analogies. Both hosts emphasize practicality and realism rather than rigid rules.
Summary:
Progressive resistance training—where you regularly increase the challenge of your workouts—is key to maintaining and building muscle throughout life. Start wherever you are and progress at a pace you can sustain, focusing on both variety and consistency. Science and history show the tried-and-tested benefits: longer, healthier lives with less frailty. Whether you’re aiming for functional strength or simply to “get out of bed in the morning without pain,” keep moving, mix it up, eat well, and don’t stress about the perfect plan—just do the work.